abnormal smear :( please help!

Hi ladies,

I could do with a bit of advice to calm me down. I had an abnormal smear and sent straight for colposcopy, results were "atypical glandular cells" borderline ... I shouldn't have asked the nurse the exact cells on the phone because then I start googling n driving myself mad. when I went for the colposcopy, on the notes that the doctor had it did say possible fungal infection ... now the glandular cells are the ones further up the canal whereas the squamous ones are on the surface of the cervix which can obviously be seen better for any changes. during the colposcopy he could actually see the abnormal area on the surface of the cervix which is odd given the fact my smear had come back saying that the abnormal glands were the ones in the canal rather than the ones on the surface of the cervix. im so confused ... im getting worried now theres something going on further up that they have missed. my head is just in a mess has anyone else had an abnormal smear where the abnormality was in the cervical canal rather than being on the surface of the cervix. Thanks so much ladies xx

I have had several abnormal smears and two colposcopies, but they never mentioned what kind of cells they were. I would try not to worry until you know more. Are you on hormonal contraception by any chance, or have you been in the relatively recent past? There is something called cervical ectropion, which most often happens when you've been on hormonal contraceptives or another synthetic hormone (though it can also happen for other reasons too), where basically the cells in the cervical canal migrate to the outside edge of the cervix. It's totally normal and harmless, just the hormones make one kind of cell spring up in another place where they aren't usually found. It all goes back to normal once you've been off the pill for a while. But I would suspect if you do have cervical ectropion (I do, my doctor wasn't bothered at all and said it will go away eventually), then if the cells in the canal are glandular ones, then it will be glandular cells you have on the outside opening of the cervix, rather than squamous ones. It is also visible to the naked eye too, so that could also be what he meant when he said he could see them. I had an exam recently and the doctor told me she could see them (while assuring me it was normal and fine). They're just a different colour than the usual cells on the outside of the cervix so easy to spot. If you look at photos, it's actually sort of awful looking because it looks irritated and like it should be a bad thing! But don't worry, it's not, just two different colour tissues that mean nothing.

As for the abnormal cells, I had several years of abnormal smears and 90% of the time, they sort themselves out and go back to normal and you go back to having clear smears again. Mine took a couple years to clear, but I've had only normal results for the past probably 6 years now.

Endocervical glandular abnormalities are often related to cervical abnormalities, so what they found actually does make sense. Actually, most abnormalities arise right in the transition zone where the cell types transition from glandular to squamous cells, so for that reason, it can be possible for both cell types to be affected if that's the region where the abnormality originated. Does that make sense? Then, if the abnormality spreads towards/onto the cervix, they can see it during a colpo because they dye the cervix with iodine, and areas with abnormality stain differently with the iodine than normal cervix areas.

Did they do an HPV test, or take a biopsy or curettage sample during the colpo? As MindUtopia said, many cervical lesions do resolve on their own. Once it's been identified, your physician will follow it to make sure it doesn't progress. Often this is repeat paps every 6 months until the paps come back negative. If the lesion is identified as high grade or above, they will surgically remove the lesioned area. Paps typically go back to negatives right away, because the surgeon ensures that the entire lesion is removed. Even once they return to negative paps, the patient is still followed closely for several years to ensure normal health. I know it sounds like a whole process, but all of this is what has made such an impact on the huge decrease in cervical cancer. I hope this helps to explain what you can expect for follow up care, and to help you feel less stressed about it.

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